Organization
MEMORIAL MEDICAL CENTER
Active
Parent organization
MEMORIAL MEDICAL CENTER
Other names
Centegra Hospital Woodstock
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL MEDICAL CENTER
Authorized official
DAVID TOMLINSON (CIO & CFO)
(815) 788-5831
Entity
Organization
Contact information
Practice address
527 W SOUTH ST, WOODSTOCK, IL 60098-3756
(815) 338-2500
(815) 334-3948
Mailing address
527 W SOUTH ST, WOODSTOCK, IL 60098-3756
(815) 338-2500
(815) 334-3948
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0001503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1159
BLUE CROSS
IL
Enumeration date
08/07/2006
Last updated
03/21/2014
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